The Norman Regional Hospital Authority in Norman, Oklahoma, a former hospital administrator, and six radiologists have agreed to pay the U.S. government more than $1.6 million to settle a whistleblower’s False Claims Act lawsuit. It was alleged that the Defendants improperly billed Medicare for radiological services that did not qualify for reimbursement. The $1,618,750 settlement resolves the suit filed in federal court in Oklahoma City by Dr. Lance Garber, a radiologist formerly employed by Norman Regional. Dr. Garber filed the lawsuit under the whistleblower provisions of the False Claims Act, which authorizes private individuals to sue on behalf of the federal government. The U.S. Department of Justice (DOJ) investigated Dr. Garber’s claims and elected to back the lawsuit.
Dr. Garber and the U.S. alleged that Norman Regional and the other Defendants were billing Medicare for diagnostic services performed by radiological practitioner assistants (RPAs) without the required supervision of physicians. The U.S. Attorney for the Western District of Oklahoma said in a statement:
There are certain radiological diagnostic services that require ‘personal’ supervision. This means that a physician must be in the room supervising the RPA when the RPA performs the service. If a physician is not in the room, the service cannot be billed to Medicare.
Dr. Garber will receive $291,375, about 18 percent of the settlement, as a whistleblower award for helping the U.S. recover the Medicare funds. The Defendants also agreed to pay more than $31,000 for Dr. Garber’s legal expenses.
Source: U.S. Attorney’s Office for the Western District of Oklahoma
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